title: Dysregulation of diurnal salivary cortisol production is associated with spontaneous preterm delivery: a pilot study.
abstract: OBJECTIVE
  The purpose of this study was to evaluate whether the diurnal fluctuation of salivary cortisol and its overall diurnal secretion are associated with the length of gestation in patients who were admitted to the hospital with an assigned diagnosis of possible preterm labor (PL) at a gestational age of 28-33 weeks.
  
  
  METHODS
  In 22 patients, maternal saliva samples were collected for a cortisol assay 4 times per day (8 AM, 12 AM, 4 PM and 8 PM) on day 4 and day 6 after antenatal corticosteroid prophylaxis to prevent neonatal respiratory distress syndrome.
  
  
  RESULTS
  Eight patients who ultimately delivered before term (32.6 ± 1.7 gestation weeks) showed an inverted fluctuation of salivary cortisol on both days 4 and 6, morning cortisol levels being significantly lower than evening levels. In contrast, in 14 patients who delivered at term (39.5 ± 0.6 gestation weeks), the physiological diurnal fluctuation of salivary cortisol was maintained. In addition, a distinctive feature of women delivering before term was a significantly hampered salivary cortisol diurnal production measured on day 6.
  
  
  CONCLUSIONS
  Corticoadrenal activity is dysregulated and anticipates very preterm delivery in women with an assigned diagnosis of possible PL.
authors.affiliation: Department of Physiology and Pharmacology V. Erspamer, Sapienza University of Rome, Italy.
authors.forename: Francesca Romana
authors.initials: FR
authors.lastname: Patacchioli
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Perrone
authors.forename: Lucia
authors.initials: L
authors.lastname: Merlino
authors.forename: Simona
authors.initials: S
authors.lastname: Simeoni
authors.forename: Elisa
authors.initials: E
authors.lastname: Bevilacqua
authors.forename: Oriana
authors.initials: O
authors.lastname: Capri
authors.forename: Paola
authors.initials: P
authors.lastname: Galoppi
authors.forename: Roberto
authors.initials: R
authors.lastname: Brunelli
mesh_terms: D000328:Adult; D002940:Circadian Rhythm / Q000502:physiology*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism*; D007752:Obstetric Labor, Premature / Q000378:metabolism*; D010865:Pilot Projects; D011247:Pregnancy; D011446:Prospective Studies; D012463:Saliva / Q000378:metabolism*
chemical_list: D006854:Hydrocortisone